Chargemaster

The Sioux Falls Specialty Hospital, LLP (“Hospital”), determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Patients should keep in mind that price is just one of multiple factors to be considered in determining where to receive care. We utilize a “packaged” billing approach whereby we do not charge for every item used, but rather incorporate numerous standard service and supply items into the procedure code prices. Other factors, such as quality of care, may also be considered. We score consistently high in patient satisfaction as publicly reported by the Centers for Medicare and Medicaid Services (CMS) https://www.medicare.gov/hospitalcompare/ and on www.sfsh.com. Individuals with questions about costs of services and other financial information should contact the Pre-Authorization Department at 605-444-8791. Insured patients seeking information about potential out-of-pocket costs should also consider contacting their insurers for further information.